Right On: Obamacare mandates: Goodbye and good riddance

OPINION — Democratic Sen. Chuck Schumer says that ending Obamacare mandates will kick 13 million people off government health care.

So how many people will be kicked off? Exactly zero. That’s right, not one.

Obamacare’s bronze, silver, gold and platinum insurance policies all will be available for their previously announced premiums for those who want them. Ditto for Medicaid: No one loses eligibility.

Republicans ended the least popular aspect of Obamacare by getting rid of the penalty for those who choose not to buy health insurance.

All this may come as a shock to readers who get their news from the mainstream media or to policy wonks who follow Congressional Budget Office projections.

The CBO inexplicably projected that 5 million of the 13 million who supposedly will be kicked off are current Medicaid recipients. The Republican law says not one word about Medicaid. And since Medicaid is free to the recipient, why would anyone leave the program?

Democrats enacted the Obamacare mandate as a penalty to force younger, healthy people to buy health insurance with premiums set high enough to cover older people under age 65 and the chronically ill. Needless to say, these inflated premiums were a shock to the young and healthy.

For example, in 2016 the average Obamacare annual premium was $5,712 while in 2014 median health care spending was $702 per year. More than 6 million households decided that paying the penalty was a far better value.

Sen. Tim Scott said, “Eighty percent of the folks who are paying this tax are folks who live in a household under $50,000. If we’re talking about doing the right thing for the middle class, we’re talking about doing the right thing for hard-working Americans, here’s a good place to start cutting their taxes.”

Ironically, while running against Hillary Clinton in the 2008 primaries, Obama said that using an individual mandate to solve the problem of the uninsured would be like trying to cure homelessness by ordering people to buy a home.

But then again he’s the one who said if you like your doctor, you can keep your doctor.

Millions haven’t signed up for Obamacare in large part because both premiums and deductibles have risen year after year. Doctor networks are growing more restrictive as doctors refuse to accept low reimbursement rates.

Obamacare is becoming government-funded insurance for older people under age 65 and the infirm. As younger people opt out, premiums grow ever higher. That in turn encourages even more young people to drop out.

With mandates gone, Obamacare’s other flaws cry out for repeal and replace.

Obamacare enthusiasts proudly point to 23 million previously uninsured folks who gained coverage under the law. In 2018 about 8.8 million of them will buy health insurance on government-run insurance exchanges.

The other 14 million are now enrolled in Medicaid, government-paid medical coverage for the poor. Of these, about 10 million were newly eligible under the act while the other 4 million were eligible previously but enrolled as a result of Obamacare publicity.

So has expanded Medicaid made them healthier?

As reported in the prestigious New England Journal of Medicine, the so-called Oregon Experiment showed Medicaid “generated no significant improvements in measured physical health outcomes.” Its only accomplishments worth mention were increased diabetes detection and lower rates of depression.

Unsurprisingly, Medicaid did “increase the use of health care services … and reduce financial strain.” Free stuff usually does.

Like Medicaid, Obamacare insurance is required to include a variety of wellness and preventative care services, adding significantly to its cost. While prevention sounds like a good idea, as Oregon demonstrated it hasn’t improved overall health outcomes.

Oregon provided a second Obamacare data point: widespread abuse. Last year the state found that half the people receiving free Medicaid health care no longer qualified. Taking license by extrapolating that finding to the country at large, 7 million of Obamacare’s new Medicaid enrollees might no longer qualify.

Maybe that’s what Schumer meant when he said millions would be kicked off health care.

In a widely cited article, the Wall Street Journal reported that about 25 percent of Medicaid enrollees are prescribed opioids, a far higher rate than in the population at large. A significant amount is resold on the black market yielding a nice, off-the-books profit for Medicaid enrollees and feeding the nation’s opioid epidemic.

Enacting Obamacare, Democrats promised to bend the health care spending curve. They’ve kept that promise by bending it upward. Adjusted for inflation, national health care spending per capita rose 1.7 percent per year from 2003-10. From 2010-16, per capita costs rose 1.9 percent per year.

With Obamacare failing by most objective measures, let’s hope ending the mandate is Republican’s first step toward repeal and replace. If they fail and Democrats retake congressional majorities and the White House, we can expect single payer, government run health care.

History shows that Democrats’ knee-jerk answer to any failing program is always to increase government control and funding. When will they learn?

Howard Sierer is an opinion columnist for St. George News. The opinions stated in this article are his own and may not be representative of St. George News.

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About the Author

Howard Sierer moved to St. George in 2000 after living on both coasts and places in between. He worked as a satellite systems engineer and program manager, finishing his career managing fiber optic communications systems development.

15 Comments

The ACA always had two noticeable Achilles heals: the individual mandate and the unfortunate way the bill was passed. The left in charge of the bill’s passage knew the mandate wasn’t a clean option but chose to accept its flaws which ultimately is leading to the Act’s dismantling.

The problem is no one has devised a better option for replacement. In a decade of zeal for repeal the right exposed it had no substantive solution and Americans know this. While the ACA had flaws it also has become rather popular and provided real solutions to decades of health insurance problems. Millions of Americans will be harmed if they repeal the ACA without maintaining certain protections, like preventing insurance companies from dropping coverage of pre-existing conditions (normally for first year if history holds up). That alone is a major impediment to middleclass workers who are often defined by the need to be geographically mobile to move up the ladder. I know my family can’t risk a year of out of pocket expenses for pre-existing conditions.

Howard has made important statements here but once again does so from partisan antagonism. Where are the solutions that should be expected in dismantling a major piece of legislation? I’m guessing from his biography he doesn’t have to worry like most of us barely clinging to the middle class. Folks who have experienced the nightmare of healthcare costs don’t talk so flippantly about the issue. We need more people finding financial security in the middle class range, not less, and we know healthcare burdens have been a problem for decades in that regard. And until we stop hearing the outdated, pedantic retorts of partisans like Howard its going to be hard to believe they actually care for the majority of Americans just trying to financially survive in the mess their generation created.

You and the others have been railing against Obamacare for YEARS shouting “Repeal and Replace!!” Your party currently holds the House, Senate and the White House and it’s been that way for a year. Where is your parties proposal for replacement?

What happens now is a rerun of years before the ACA when people go to the ER for healthcare. Unless your employer helps pay for health insurance, you are essentially SOL. Premiums for those of us who do have insurance will go up to pay for those who dont. America needs a public option.

The RNC is doing the slow bleed of the ACA because they know millions of citizens benefited from changes mandated by it. They saw and heard the pushback in 2017. Sadly, most citizens miss the cloak and dagger actions in our government that leave Acts like the ACA in place but functionally kill them. The RNC is clearly concerned about midterms and know lower to middleclass Americans are already concerned about the tax plan. They can only risk so much.

Your predictions are likely right. Without affordable, regular access to GPs people will wait until they require emergency service. The cycle continues. I wish conservatives would provide a solution that didn’t leave millions without functional healthcare or just accept legislation from the left. The ACA was imperfect, highly in several ways, but it at least tried to move us in the right direction. The right just seems fine with the status quo of the past.

Right wingers have been railing against Obama care for almost a decade now. They have tried and failed to dismantle the law 50+ times. They have had 10 years to come up with a plan to replace it with and have failed to do so. I’m convinced that Republicans want a return to the “Every Man for Himself” plan that left most Americans with one choice; stay sick/injured or be in debt for the rest of your life while everyone else covers the bill by paying THOUSANDS more that they should for any given procedure.

IMO, Socialized medicine is the way to go. I don’t mind having to pay an extra couple bucks from my paycheck if it means that I won’t be in debt forever because I broke my arm.

I’m not sure what the best solution is going forward but I think we both agree that it’s not what existed before the ACA. We are in for a bumpy ride if they don’t have a genuine attempt at replacement in place soon.

I hope hospitals and doctors start requiring cash payment up-front from anyone seeking medical care who doesn’t have insurance. You now have the right to be uninsured without the mandate penalty, so doctors and hospitals should send you packing if you don’t have the cash on-hand to pay your bill.

I never liked the mandate, but like many have said how are we going to pay for the uninsured who use the ER as healthcare and don’t pay the bill. My insurance rates have gone up every year at my current job. Pretty soon the only option will be a high deductible plan that cost the employers less and the patient more. Maybe if these fat and lazy people would stop smoking and eating at fast food restaurants they wouldn’t have to be treated for diabetes, COPD, and heart problems. Our body if maintained correctly can heal itself in most cases or prevent them from happening. We are stuck paying for people who think they are entitled to healthcare. Healthcare is not a god given right as Christians often say. The only people who should be entitled to healthcare are our children. Universal healthcare would be great if we were a healthy nation, but in my opinion it will never happen in this country until we start being responsible for our own health. One option that should made in a new health care bill is the medicare option, we should be able to opt of of paying for medicare if we don’t plan on using it or get a full refund once we reach the age age of 65. If medicare goes bankrupt I better get a refund, people pay medicare so they can use it when they retire, not to pay for the current people on medicare. The system is broke and needs to be built from the ground up, but not by the current congress. They are in it to make money from giant pharmaceutical company’s and we all know how that has worked out for the country. This problem can’t be fixed by liberals or conservatives, it must be addressed by the people. Take care of yourself and save the ER for true emergencies like car accidents and serious health emergencies, not for the sniffles and other things that can wait until your regular doctor can address. Eat healthy, drink lots of water and get rest will always make things better.

I think we all wish it were as easy as taking care of ourselves. For millions of Americans it’s simply not. Disease and chronic health problems are complex and don’t abide by that theory. I’m guessing from your comments that you aren’t one of the lucky folks who have had diseases that stressed them physically or financially for no fault of their own. You can’t financially prepare enough for MS, cancer, stroke, or the long list of other diseases that just happen to fellow citizens. Count yourself lucky.

Numbers bare out the notion that a population with access to affordable, functional, preventative healthcare benefits society: less strain on community in long run, higher quality of life, higher GDP, fewer sick days. Yeah, the adjustment period sucks (ie going from every man for themselves to some form of cost sharing) but it pays off in dividends. Its the reason we have Social Security, though socially we have forgotten how horrible it was for individuals and communities to be destitute in old age. Call it what you may but having a large portion of society constantly poor helps only a handful of citizens and harms the majority, directly and indirectly.

Healthcare is not in the Constitution. The provision of health care is not mentioned in our Constitution or the Bill of Rights. Our Founding Fathers rightfully focused on life, liberty and justice. Health care is a service… not provided by the government.